Title
SARS-CoV-2 seroprevalence and associated factors in Manaus, Brazil: baseline results from the DETECTCoV-19 cohort study
Date Issued
01 September 2021
Access level
open access
Resource Type
journal article
Author(s)
Lalwani P.
Salgado B.B.
Filho I.V.P.
da Silva D.S.S.
de Morais T.B.d.N.
Jordão M.F.
Barbosa A.R.C.
Cordeiro I.B.
Neto J.N.d.S.
de Assunção E.N.
dos Santos R.O.
Carvalho N.O.
Sobrinho W.B.S.
da Costa C.F.
de Souza P.E.
de Albuquerque B.C.
Filho S.A.
Lalwani J.D.B.
Publisher(s)
Elsevier B.V.
Abstract
Background: Manaus, located in the Brazilian rainforest, has experienced two health system collapses due to the coronavirus disease 2019 (COVID-19) pandemic. However, little is known about which groups among the general population have been most affected. Methods: A convenience sampling strategy via online advertising recruited 3046 adults between 19 August 2020 and 2 October 2020. Sociodemographic characteristics, COVID-19-related symptoms, COVID-19 testing, self-medication and prescribed medications were recorded. Serum anti-severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) nucleocapsid immunoglobulin G antibodies were measured with an enzyme-linked immunosorbent assay. Prevalence ratios (PR) were obtained using cluster-corrected and adjusted Poisson's regression models. Results: A crude positivity rate among asymptomatic and symptomatic individuals was estimated at 29.10%, with maximum possible seroprevalence of 44.82% corrected by test characteristics and an antibody decay rate of 32.31%. Regression models demonstrated a strong association towards marginalized low-income and vulnerable residents with limited access to health care. The presence of a COVID-19 case [PR 1.39, 95% confidence interval (CI) 1.24–1.57] or death (PR 2.14, 95% CI 1.74–2.62) in a household greatly increased the risk of other household members acquiring infection. The seroprevalence of SARS-CoV-2 was higher among those who self-medicated to prevent infection (PR 1.36, 95% CI 1.27–1.46). Conclusions: Disproportionate socio-economic disparity was observed among the study participants. The syndemic nature of COVID-19 in the Amazon region needs differential policies and urgent solutions to control the ongoing pandemic.
Start page
141
End page
150
Volume
110
Language
English
OCDE Knowledge area
EpidemiologÃa
Subjects
Scopus EID
2-s2.0-85112591251
PubMed ID
Source
International Journal of Infectious Diseases
ISSN of the container
12019712
Source funding
World Health Organization
Sponsor(s)
JDBL was supported by funds from the Ministry of Education, Brazil. PL received funding from the Fundação de Amparo à Pesquisa do Estado do Amazonas (FAPEAM). JDBL and PL were supported by the World Health Organization (WHO) Unity Studies, a global sero-epidemiological standardization initiative, with funding to WHO by the COVID-19 Solidarity Response Fund and the German Federal Ministry of Health COVID-19 Research and Development. BBS, IVPF, ARCB and WBSS received scholarships from CAPES. DSSS, TBNM and MFF received scholarships from FAPEAM.
PL and JDBL were the principal investigators of this study and acquired the necessary funding. PL and JDBL conceived the study with input from CFC, PES, BCA, CAG and RVA. Antigen design and protein purification were performed by PL, BBS, IBC, JNSN, ENA and SAF. Sample collection was led by JDBL with assistance from CFC, PES and BCA. The laboratory set-up and sample processing were coordinated by PL and BBS. BBS, IVPF, DSSS, TBNM, MFJ, ARCB, ROS, NOC and WBSS processed blood samples, performed laboratory testing, collected data and approved the test results, supervised by PL. PL, BBS and JDBL coordinated data acquisition and data management. Data were cleaned and prepared by PL, BBS and RVA. Statistical analyses and data visualization were performed by PL and CAG, and RVA led the statistical analyses. PL, JDBL, CAG and RVA wrote the manuscript. All authors revised and approved the final version of this manuscript. JDBL was supported by funds from the Ministry of Education, Brazil. PL received funding from the Fundação de Amparo à Pesquisa do Estado do Amazonas (FAPEAM). JDBL and PL were supported by the World Health Organization (WHO) Unity Studies, a global sero-epidemiological standardization initiative, with funding to WHO by the COVID-19 Solidarity Response Fund and the German Federal Ministry of Health COVID-19 Research and Development. BBS, IVPF, ARCB and WBSS received scholarships from CAPES. DSSS, TBNM and MFF received scholarships from FAPEAM. The Research Ethics Committee of Federal University of Amazonas approved this study (CAAE:34906920.4.0000.5020) in accordance with Brazilian law, and the Declaration of Helsinki. All participants gave oral and written consent prior to enrolment. The authors wish to thank Comitê de Enfrentamento de CoronavÃrus and Escola de Enfermagem de Manaus at Universidade Federal do Amazonas for logistical support. In addition, the authors are grateful to Prof. Marcus Lacerda for providing COVID-19 patient serum samples. Finally, the authors wish to thank Prof. Bernardo Horta and Prof. Claudio Pannuti for suggestions and diligent proofreading of this paper. The DETECTCoV-19 study team (alphabetical order): Aldina Iacy Paulain Holanda, Ana Lúcia Silva Gomes, Ana Paula Souza de França, Anna Paula de Carvalho, André Victor Rabelo Monteiro, Andressa dos Passos Santos, Antonia de Sousa Teixeira, Antônio Vinicius Soares de Souza, Beatriz Pinheiro, Bianca Pires dos Santos, Brenda Pereira Farias, Bruno Nicolau Paulino, Caio Lúcio Andreola da Silva, Carlos Eduardo Faresin e Silva, Cinthya Iamile Frithz Brandão de Oliveira, Dalila de Alcântara Martins, Diego Castro Squinello, Eline Araújo de Oliveira, Elisson Denny da Costa Carvalho, Evillyn Fernandes Da Costa, Fernanda Rodrigues Fonseca, Fernanda Guilhon Simplicio, Fernanda Serrão Pereira, Gabriele Pimentel Sinimbu, Giane Alves da Silva, Iago Sampaio Fernandes da Costa, Ingrid Silva Correia, Ilia Gilmara Carvalho dos Santos, Jackeline Vieira Guimarães, Jessica Vanina Ortiz, Juliana Correa Romana, José Renato Pereira Cavallazzi, Josineide de Oliveira Novo França, Kerollen Runa Pinto, Marcos Victor Silva Oliveira, Maria Clara Ramos da Silva, Maria Fiamma Farias Freitas, Maria Francisca de Souza Rodrigues, Marne Carvalho de Vasconcellos, Mariza Quercio Machado, Marizete Candido Moraes, Matheus da Silva Damasceno, Michelle Araújo Ruiz, Milena Maria Cardoso de Lemos, Neila Soares Picanço, PatrÃcia Danielle Oliveira de Almeida, Priscilla Mendes Cordeiro, Rayara Gonzaga Maia, Rebeca Cavalcante Pires, Regiane Carneiro Bezerra, Romeu Santos de Souza, Susy Cavalcante Harjani, Tamiris Moraes Siqueira, Valdenora PatrÃcia Rodrigues Macedo, Vitor Batista de Souza and Wellington Barbosa de Melo.
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